What Does DNFB Mean to Billing and Why Does It Matter?
Explore DNFB in healthcare billing. Understand its critical role in revenue cycle management and financial performance.
Discharged Not Final Billed (DNFB) is a metric in healthcare revenue cycle management. It represents patient accounts where a patient has been discharged from a healthcare facility, but the final bill for their services has not yet been generated and sent to the payer. This indicates a delay in the billing process, impacting a healthcare organization’s financial health.
Defining DNFB in Billing
DNFB refers to patient accounts where clinical care is complete, meaning the patient has left the facility, but the administrative process of creating and submitting a complete bill is pending. Accounts enter DNFB status after discharge and remain there until all necessary information is gathered, coded, and verified for billing. This period serves as a holding queue for accounts requiring further action before a claim can be sent to an insurance company or patient.
The DNFB metric measures accounts held in this billing queue, signifying that services have been rendered but payment cannot yet be pursued. It is an important internal performance indicator used by healthcare organizations to assess revenue cycle efficiency. A healthcare facility often sets a hold period of three to five days to allow for the collection of all documentation and charges before a claim is generated.
Reasons for DNFB Status
Several factors contribute to accounts entering or remaining in DNFB status, preventing timely bill finalization. One frequent reason is missing or incomplete clinical documentation, such as absent physician notes, surgical reports, or discharge summaries. These are necessary for accurate medical coding. Without comprehensive documentation, coders cannot assign correct medical codes, delaying the billing process.
Coding discrepancies or backlogs also contribute to DNFB. Errors in coding or delays due to case complexity or insufficient staffing can prevent a bill from being finalized. Authorization issues, like missing or incorrect insurance approvals, can also hold accounts in DNFB. Pending charge capture, where services performed have not yet been recorded or reconciled, directly delays creating a complete bill.
Operational Impact of DNFB on Billing
A high volume of DNFB accounts directly impacts a healthcare organization’s financial health and billing operations. When accounts remain in DNFB, revenue is delayed, as bills cannot be sent to payers until all issues are resolved. This delay increases accounts receivable (AR) days, the average time to collect payments after a claim is billed. An ideal AR day count is typically 30 to 40 days; high DNFB pushes this higher, indicating inefficiencies.
Delayed revenue collection can lead to cash flow challenges for healthcare providers. Organizations lose potential interest income on unbilled amounts, and prolonged delays can result in claims being denied if submission deadlines are missed. This creates an administrative burden on billing staff, who must spend time investigating, correcting, and resolving issues that prevent final billing. This rework reduces billing department efficiency and can contribute to staff burnout.